1. Field of the Invention
The invention relates to drug delivery implantable medical devices, one example of which is a stent. More particularly, the invention relates to abluminal, multilayer coating constructs for drug-delivery stents.
2. Description of the Background
This invention relates to radially expandable endoprostheses, which are adapted to be implanted in a bodily lumen. An “endoprosthesis” corresponds to an artificial implantable medical device that is placed inside the body. A “lumen” refers to a cavity of a tubular organ such as a blood vessel. A stent is an example of these endoprostheses. Stents are generally cylindrically shaped devices, which function to hold open and sometimes expand a segment of a blood vessel or other anatomical lumen such as urinary tracts and bile ducts. Stents are often used in the treatment of atherosclerotic stenosis in blood vessels. “Stenosis” refers to a narrowing or constriction of the diameter of a bodily passage or orifice. In such treatments, stents reinforce body vessels and prevent restenosis following angioplasty in the vascular system. “Restenosis” refers to the reoccurrence of stenosis in a blood vessel or heart valve after it has been treated (as by balloon angioplasty, stenting, or valvuloplasty) with apparent success.
The treatment of a diseased site or lesion with a stent involves both delivery and deployment of the stent. “Delivery” refers to introducing and transporting the stent through a bodily lumen to a region, such as a lesion, in a vessel that requires treatment. “Deployment” corresponds to the expansion of the stent within the lumen at the treatment region. Delivery and deployment of a stent are accomplished by positioning the stent about one end of a catheter, inserting the end of the catheter through the skin into a bodily lumen, advancing the catheter in the bodily lumen to a desired treatment location, expanding the stent at the treatment location, and removing the catheter from the lumen. In the case of a balloon expandable stent, the stent is mounted about a balloon disposed on the catheter. Mounting the stent typically involves compressing or crimping the stent onto the balloon. The stent is then expanded by inflating the balloon. The balloon may then be deflated and the catheter withdrawn. In the case of a self-expanding stent, the stent may be secured to the catheter via a retractable sheath or a sock. When the stent is in a desired bodily location, the sheath may be withdrawn which allows the stent to self-expand.
Stents have been made of many materials including metals and polymers. Polymeric materials include both nonbioerodable and bioerodable plastic materials. The cylindrical structure of stents is typically composed of a scaffolding that includes a pattern or network of interconnecting structural elements or struts. The scaffolding can be formed from wires, bars, tubes, or planar films of material rolled into a cylindrical shape. Furthermore, the pattern that makes up the stent allows the stent to be radially expandable and longitudinally flexible. Longitudinal flexibility facilitates delivery of the stent, and rigidity is needed to hold open a body lumen. The pattern should be designed to maintain the longitudinal flexibility and rigidity required of the stent.
Stents are used not only for mechanical intervention but also as vehicles for providing biological therapy. Biological therapy can be achieved by medicating the stents. Medicated stents provide for the local administration of a therapeutic substance at the diseased site. In order to provide an efficacious concentration to the treated site, systemic administration of such medication often produces adverse or even toxic side effects for the patient. Local delivery is a preferred method of treatment in that smaller total levels of medication are administered in comparison to systemic dosages, but are concentrated at a specific site. Local delivery thus produces fewer side effects and achieves more favorable results.
A medicated stent may be fabricated by coating the surface of either a metallic or polymeric scaffolding to produce a drug reservoir layer on the surface. The drug reservoir layer typically includes a polymeric carrier that includes an active agent or drug. To fabricate a coating, a polymer, or a blend of polymers, can be applied on the stent using commonly used techniques known to those having ordinary skill in the art. A composition for application to a stent may include a solvent, a polymer dissolved in the solvent, and an active agent dispersed in the blend. The composition may be applied to the stent by immersing the stent in the composition, by direct application, by roll coating, or by spraying the composition onto the stent. The solvent is allowed to evaporate, leaving on the stent strut surfaces a coating of the polymer and the active agent impregnated in the polymer.
A drug delivery stent coating should meet several well-known criteria including mechanical integrity, controlled release of the drug, and biocompatibility. Active agents within polymer-based coating layers can interfere with the mechanical integrity of a coating since active agents negatively impact the coating mechanical properties, and the ability of a polymer matrix to adhere effectively to the surface of the stent. Increasing the quantity of the active agent reduces the effectiveness of the adhesion. A primer layer can serve as a functionally useful intermediary layer between the surface of the device and an active agent-containing or reservoir coating, or between multiple layers of reservoir coatings. The primer layer provides an adhesive tie between the reservoir coating and the device. In addition, successful treatment of a diseased site with a medicated stent often requires that the rate of release of the active agent or drug be within a prescribed range. A barrier or polymeric topcoat layer above a reservoir layer serves the purpose of controlling the rate of release of an active agent or drug.
Furthermore, since the presence of foreign polymers can adversely affect the body, it is generally desirable to limit exposure of the polymer on a coating to the body. Therefore, a stent may also include a biobeneficial coating over a reservoir layer and/or topcoat layer to improve the biocompatibility of the coating. However, in general, it is appropriate to use no more polymer than is necessary to hold the drug on the stent and to control its release. This is particularly the case for coatings that include bioabsorbable polymers since the polymer is absorbed in vivo. Therefore, it would be advantageous to reduce the amount of coating material on a stent without adversely impacting the stent's treatment capabilities.
Additionally, the presence of a topcoat layer, such as a poly(ester amide) (PEA) layer, on a luminal stent surface can have a detrimental impact on a stent's deliverability and coating mechanical integrity. The PEA coatings change the coefficient of friction between the stent and the delivery balloon. In addition, some PEA polymers have structures that cause them to be sticky or tacky. If the PEA either increases the coefficient of friction or adheres to the catheter balloon, the smooth release of the stent from the balloon after deflation is compromised. PEA stent coatings often exhibit extensive balloon shear damage post-deployment as well, which could result in a thrombogenic luminal stent surface. Therefore, it would be desirable to limit exposure of the balloon to the PEA topcoat layer.